MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
HINES, KRISTI KATHERINE

Facility DVN
001482284

Phone
(573) 259-4832

Physical Address
1151 LILAC DR
SULLIVAN
MO 63080-2352

Owner
HINES, KRISTI KATHERINE

Mailing Address

Provider/Director
HINES, KRISTI KATHERINE

E-mail Address
kristiphines@gmail.com

Incorporated

Child Care Specialist
SHARLENE WHEATLEY

Age Range
BIRTH - 12 YEARS

Capacity
10

Facility Type
FAMILY HOME

Limitations
IF ONLY 4 CHILDREN PRESENT, ALL CHILDREN MAY BE UNDER AGE 2 WITH 1 ADULT CAREGIVER; UP TO 10 CHILDREN IN CARE NO MORE THAN 2 CHILDREN UNDER AGE 2 WITH 1 ADULT CAREGIVER; UP TO 10 CHILDREN IN CARE NO MORE THAN 4 CHILDREN UNDER AGE 2 WITH 2 ADULT CAREGIVERS; UP TO 6 CHILDREN IN CARE NO MORE THAN 3 CHILDREN UNDER AGE 2 WITH 1 ADULT CAREGIVER

Inspection Information

Date
08/02/2024

Arrival Time
12:15 PM

Departure Time
1:33 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2481927579

Document	Document-Date
OWNER/PROVIDER REFERENCES	06/08/2000
ASSISTANT APPROVAL REQUEST	04/20/2012
SAMPLE FORMS	07/26/2000
SAMPLE WEEKLY MENU	07/26/2000
DAILY SCHEDULE	07/26/2000
POLICIES	08/07/2000
CHILD CARE/DISCIPLINE POLICIES	08/07/2000
DIAGRAM/OUTDOOR	07/26/2000
DIAGRAM/INDOOR	07/26/2000
APPLICATION	07/08/2020
FIRE/SAFETY INSPECTION	07/13/2023
EQUIPMENT LIST	07/13/2023
SANITATION INSPECTION	05/25/2023
ANNUAL DECLARATION	07/10/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	07/13/2023

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:00PM	4:30PM	7/17/2023
6:40AM	7:10AM	7/17/2023

Inspection determined facility to be in compliance with licensing rules.

Open Violations: 2

NOTE

The licensee is responsible for compliance with all licensing rules, including but not limited to the rules listed on this compliance report form.

Attendance at Time of Inspection

Total Staff 2

Total Children 10

Staff	Child	Class Age	Note
1	10	MIXED	Provider Kristi Hines was with ten children, 0ne=19 month, two-2year olds, one-3 year old, one-4 year old,five-5 year olds
1	0	NO CHILDREN IN ATTENDANCE	Additional adult household member present in the home was Robert Hines he was sleeping in master bedroom.